DR. KYONG MIN YI (M.D.) – Surgery Physician, NPI 1306846399
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. KYONG MIN YI (M.D.)
McKenzie-Willamette Medical Center, 1460, G Street, Springfield, Lane County, Oregon, 97477, United States
SPRINGFIELD, OR 974774112
Phone: (541) 726-4406
Type: Location
2101 Forest Ave
Suite 100
San Jose, CA 951281448
Phone: (408) 993-8568
Fax: (408) 993-8555
Type: Location
PO BOX 3379
TRUCKEE, CA 961603379
Phone: (408) 228-2357
Fax: (408) 993-8555
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-03-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040305001032 | I | General Surgery | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97477)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| Clinical Psychologist | CA | |
| Internal Medicine | CA | |
| Internal Medicine, Gastroenterology | CA | |
| - | CA | |
| Internal Medicine, Critical Care (Intensivists), Pulmonary Disease | CA | |
| Nurse Practitioner | CA | |
| Internal Medicine, Hospitalist | PA | |
| - | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA |
Reviews
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